Thanks to a partnership with Carpe Data, one of the Top 10 US auto insurers gathered evidence disproving the claimants’ assertions that they were seriously injured in the accident, paving the way for the insurer’s attorneys to obtain a favorable trial verdict and saving the insurer $500,000 in damages.
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The Case:
A team of claim handlers at one of the largest auto insurers in the US combined advanced data analytics and investigative savvy to put the brakes on two claimants who exaggerated the extent of their injuries after being in an accident with one of the company’s customers.
The accident occurred at a busy intersection when the claimants’ vehicle, which was traveling in a bus- only lane, struck an insured customer’s car, which was turning left. An accident reconstructionist and biomechanics expert concluded that the facts of the loss did not support the occurrence of significant
injuries. However, the claimants alleged they sustained back, neck and other injuries, and both sought medical treatment over multiple years.
“The favorable outcome in this case highlights the value of partnering with Carpe Data to prevent bad actors from taking advantage of our company and our customers.”
– Senior Claim Executive, Top 10 US Auto Insurer
The Strategy:
A team of claim handlers and managers at the insurer held roundtable discussions about the case. The team’s jurisdictional knowledge and familiarity with the claimant attorney’s legal tactics, along with supporting intel gathered through internal analytics tools, enabled them to develop a sound defense
plan. But the real breakthrough came when Carpe Data’s sophisticated social media mining capabilities uncovered online posts containing videos and photos that contradicted the claimants’ deposition statements.
Carpe Data’s Online Injury Alerts showed one claimant lifting weights, doing pushups, squatting and engaging in other high-intensity activities in several videos. Similarly, Carpe Data uncovered additional evidence contradicting the second claimant’s testimony that he sustained facial lacerations. Additionally, an orthopedic independent medical examiner (IME) opined that both claimants only sustained minor soft tissue injuries in the accident and that most, if not all, of their medical care was unwarranted.
The social media posts discovered through Carpe Data, along with the IME opinion, marked the end of the road for the claimants. During the trial, the insurer’s attorneys walked through each of the relevant posts. The claimants admitted to having been untruthful about their injuries during their testimony, impeaching themselves in front of the jury, which rendered an 11-1 verdict in favor of the insurer and their customer.
The Results:
The favorable verdict prevented the insurer from having to pay $500,000 in damages sought by the claimants’ counsel, and the insurer was able to pursue the claimants for legal costs and fees resulting from the bogus claims— somewhere between $25,000 and $50,000.
A Senior Claim Executive from the insurer stated: “The favorable outcome in this case highlights the value of partnering with Carpe Data to prevent bad actors from taking advantage of our company and our customers.”
